Suture anchor and associated systems and methods

ABSTRACT

Exemplary embodiments of a suture anchor are provided that generally include a suture anchor body including a securing structure for securing the suture anchor in tissue or bone. The suture anchor body includes an internal cavity configured and dimensioned to receive therein a suture and a locking pin. Exemplary embodiments are also directed to suture anchor systems that generally include a suture anchor and a driver configured and dimensioned to interlock relative to the suture anchor. Exemplary embodiments are further directed to methods of anchoring a suture in tissue or bone that generally include providing a suture anchor, passing the suture through the suture anchor body, and driving the suture anchor into the tissue or bone.

TECHNICAL FIELD

The present disclosure relates to a suture anchor and, moreparticularly, to a suture anchor with a sliding, a non-sliding and aknotless suturing capability.

BACKGROUND

Suture anchors are common implants used in the medical industry for softtissue fixation to bone. These implants are commonly used in orthopedicapplications, such as during tendon fixation or ligament fixation tobone. Suture anchors in the industry generally include an anchor bodywhich is loaded with one or more sutures. The suture anchor can beinserted into and secured in the bone by, e.g., threads (i.e., acorkscrew design), a ribbed design (i.e., an interference screw design),a winged design (i.e., a harpoon shaped anchor), and the like. Once thesuture anchor has been secured in the bone, one or more sutures can bepassed through the soft tissue, such as a tendon or a bone, and a knotcan be tied to reduce and secure the tendon to the bone. Some sutureanchors may be preloaded with one or more sutures before the sutureanchor is to be secured in the bone. For example, a suture anchor may bepreloaded with single or multiple sutures, e.g., one to three sutures.

With reference to FIGS. 1A and 1B, alternative designs of a slidingsuture anchor known in the industry are provided. FIG. 1A shows a sutureanchor 10 which includes threads 12 on an outer surface and an eyelet 14formed with a post 16 at a proximal end of the suture anchor 10. One ormore sutures 18 can be passed around the internal eyelet 14 or post 16and the threads 12 of the suture anchor 10 can be driven into bone,while permitting the sutures 18 to slide through or around the eyelet 14and post 16. Similarly, FIG. 1B shows a suture anchor 20 which includesthreads 22 on an outer surface and an eyelet 14 formed below the threads22 with a post 26. One or more sutures 28 can be passed through the bodyof the suture anchor 20 and around the internal eyelet 24 or post 26 andthe threads 22 of the suture anchor 20 can be driven into bone, whilepermitting the sutures 28 to slide around the internal post 26 andthrough the body of the suture anchor 20. The sliding suture anchor 10,20 may be used when tying knots in the suture 18, 28 or can allowsliding knots to be utilized when tying the knot during soft tissuefixation to bone.

With reference to FIG. 1C, a non-sliding suture anchor 30 is shown. Thesuture anchor 30 can include threads 32 on an outer surface and a distaleyelet 34 external to the bulk of the suture anchor 30 body. One or moresutures 36 can be passed through the eyelet 34 and, as the suture anchor30 is secured into a bone with the threads 32, the suture 36 can belocked between the suture anchor 30 body and/or threads 32 and the boneby interference and frictional forces which prevent the suture 36 fromsliding. Since the suture 36 cannot slide through the suture anchor 30,the suture 36 can be tied using a non-sliding knot. In knotlessapplications, rather than tying a non-sliding knot, the suture 36 can beheld in place only by the frictional forces generated by the sutureanchor 30 against the bone.

However, the suture anchors illustrated in FIGS. 1A-1C do not providethe option of inserting an anchor preloaded with one or more suturesinto tissue or bone for a sliding suture, a non-sliding suture and aknotless suture technique. For example, the suture anchors 10, 20 ofFIGS. 1A and 1B can only be used for sliding suture applications, whilethe suture anchor 30 of FIG. 1C can only be used for non-sliding sutureapplications. As such, different types of suture anchors 10, 20, 30 andassociated drivers may be required by a surgeon during a single surgicalprocedure, thereby complicating the surgical procedure.

Thus, a need exists for suture anchors which provide a sliding suture, anon-sliding suture and a knotless suture capability. These and otherneeds are addressed by the suture anchors and associated systems andmethods of the present disclosure.

SUMMARY

In accordance with embodiments of the present disclosure, exemplarysuture anchors are provided that include a suture anchor body includinga securing structure, e.g., threads, an interference fit structure, aretractable harpoon, and the like, for securing the suture anchor intissue or bone. The suture anchor body includes an internal cavity,i.e., a second cavity, configured and dimensioned to receive therein asuture and a locking pin. The exemplary suture anchor can be adapted forsliding, non-sliding and knotless suturing techniques.

The suture anchor body includes an additional internal cavity, i.e., afirst cavity, located adjacent to the internal cavity configured anddimensioned to interlock with a driver for driving the suture anchorinto the tissue or bone. The internal cavity includes an internal postforming an eyelet in the internal cavity. The eyelet can be configuredand dimensioned to slidably receive the suture therethrough. The sutureanchor body can be fabricated from a group consisting of a metal, abioabsorbable material, a biocomposite material, a polyether etherketone, and the like.

In accordance with embodiments of the present disclosure, exemplarysuture anchor systems are provided that include a suture anchor and adriver. The suture anchor includes a suture anchor body including asecuring structure for securing the suture anchor in tissue or bone. Thesuture anchor body includes an internal cavity configured anddimensioned to receive therein a suture and a locking pin. The drivercan be configured and dimensioned to interlock relative to the sutureanchor.

The driver can include a driver handle and a shaft. The suture anchorbody includes an additional internal cavity to receive a distal end ofthe shaft. The driver handle includes a post for wrapping the suturethereon to lock or fixate the driver relative to the suture anchor. Thedriver includes a locking pin driver detachably secured to the lockingpin with locking means, e.g., threads, and the like. The locking pindriver and the locking pin can be axially translatable relative to thedriver handle and the shaft when the driver has been fixated relative tothe suture anchor. The internal cavity of the suture anchor can includean internal post forming an eyelet in the internal cavity. The eyeletcan be configured and dimensioned to receive the suture therethrough.Advancement of the locking pin into the internal cavity fixedly securesthe suture within the internal cavity.

In accordance with embodiments of the present disclosure, exemplarymethods of anchoring a suture in tissue or bone are provided thatinclude providing a suture anchor. The suture anchor includes a sutureanchor body including a securing structure for securing the sutureanchor in the tissue or bone. The suture anchor body includes aninternal cavity configured and dimensioned to receive therein the sutureand a locking pin. The methods include passing the suture through thesuture anchor body and driving the suture anchor into the tissue orbone.

The methods include interlocking the suture anchor with a driver fordriving the suture anchor into the tissue or bone. The methods furtherinclude wrapping the suture around a post protruding from a driverhandle. For a sliding suture application, the methods includedisengaging the driver from the suture anchor and slidably translatingthe suture through the suture anchor body. For a non-sliding sutureapplication, the methods include advancing the locking pin into theinternal cavity with a locking pin driver and fixating the sutureagainst the internal walls of the internal cavity of the suture anchor.The methods further include disengaging the locking pin driver from thelocking pin.

Other objects and features will become apparent from the followingdetailed description considered in conjunction with the accompanyingdrawings. It is to be understood, however, that the drawings aredesigned as an illustration only and not as a definition of the limitsof the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

To assist those of skill in the art in making and using the disclosedsuture anchors and associated methods, reference is made to theaccompanying figures, wherein:

FIGS. 1A-1C are side and perspective views of traditional suture anchorsof the prior art;

FIG. 2 is a side, cross-sectional view of an exemplary suture anchoraccording to the present disclosure;

FIGS. 3A and 3B are top views of an exemplary suture anchor according tothe present disclosure;

FIG. 4 is a side view of an exemplary suture anchor and driver accordingto the present disclosure;

FIG. 5 is a side view of an exemplary suture anchor and driver includinga retracted locking pin according to the present disclosure;

FIG. 6 is a side view of an exemplary suture anchor and driver includingan inserted locking pin according to the present disclosure;

FIG. 7 is a side, cross-sectional view of an exemplary suture anchor anddriver including a retracted locking pin according to the presentdisclosure;

FIG. 8 is a side, cross-sectional view of an exemplary suture anchor anddriver according to the present disclosure;

FIG. 9 is a side, cross-sectional view of an exemplary suture anchor anddriver including an inserted locking pin according to the presentdisclosure;

FIG. 10 is a side, cross-sectional view of an exemplary suture anchorand driver including an inserted locking pin according to the presentdisclosure;

FIG. 11 is a side view of an exemplary suture anchor securing a suturein tissue according to the present disclosure;

FIG. 12 is a side view of an exemplary suture anchor securing a suturein tissue according to the present disclosure;

FIG. 13 is a side view of an exemplary suture anchor securing a suturein tissue according to the present disclosure;

FIG. 14 is a side view of an exemplary suture anchor securing a suturein tissue according to the present disclosure;

FIG. 15 is a side view of an exemplary suture anchor securing a suturein tissue according to the present disclosure;

FIG. 16 is a side view of two exemplary suture anchors securing a suturein tissue according to the present disclosure; and

FIG. 17 is a side view of two exemplary suture anchors securing a suturein tissue according to the present disclosure.

DESCRIPTION OF EXEMPLARY EMBODIMENTS

Turning to FIG. 2, an exemplary suture anchor 100 is provided whichadvantageously allows sliding, non-sliding and knotless sutureapplications in a single suture anchor 100 design. The suture anchor 100can be fabricated from materials generally used in orthopedicapplications, including metal, bioabsorbable material, biocompositematerial, polyether ether ketone (PEEK), and the like. The suture anchor100 includes an anchor body 102 defining a proximal end 104 and a distalend 106. The suture anchor 100 includes a securing structure 108positioned near or on an outside surface of the anchor body 102. Thesecuring structure 108 can be used to secure the suture anchor 100within tissue and/or bone. Although illustrated as threads (i.e., acorkscrew design), in some embodiments, the securing structure 108 canbe, e.g., an interference fit, an expandable harpoon design, or anyother methods of fixation. For example, in an expandable harpoon design(not shown), the anchor body 102 can be covered with an inserter whichcan be pulled off to eject the spring-loaded harpoons from the sides ofthe anchor body 102. Thus, the inserter can maintain the harpoons in aretracted position until fixation of the suture anchor 100 is desired.In some expandable harpoon embodiments, a pin can be actuated, e.g.,pushed, to eject the spring-loaded harpoons from the sides of the anchorbody 102. The proximal end 104 can define a substantially flat plane,while the distal end 106 can define a tapered point configured to bedriven into tissue and/or bone.

The suture anchor 100 includes an internal cavity 110 which defines afirst cavity 112 and a second cavity 114. The internal cavity 110 canopen to the proximal end 104 of the suture anchor 100 and can extend inthe direction of the distal end 106. The first cavity 112 can beconfigured and dimensioned to interlock relative to a driver for drivingand securing the suture anchor 100 into tissue and/or bone. It should beunderstood that the suture anchor 100 can be driven into tissue and/orbone by initially driving the distal end 106 of the suture anchor 100into the tissue and/or bone and, for example, rotating the suture anchor100 to drive the securing structure 108 into the tissue and/or bone.

The second cavity 114 can be configured and dimensioned to receivetherein one or more sutures 116 and, optionally, a locking pin (notshown) for non-sliding suture 116 applications. The diameter of thefirst cavity 112 can be dimensioned greater than the diameter of thesecond cavity 114, forming an edge 118 between the first cavity 112 andthe second cavity 114. As will be discussed below, a distal end of thedriver can be inserted into the first cavity 112 for driving the sutureanchor 100 into tissue and/or bone and can further be used to insert alocking pin into the second cavity 114. The depth of the first cavity112 can be selected to provide sufficient support for a driver insertedinto the first cavity 112 to provide torque when driving the sutureanchor 100 into tissue and/or bone.

The suture anchor 100 includes an internal post 120 positioned withinthe second cavity 114 substantially perpendicular to the vertical axisA. The internal post 122 can divide the second cavity 114 into a topportion 122 and a bottom portion 124, i.e., an eyelet. The top portion122 can be configured and dimensioned to receive the locking pintherein, while the bottom portion 124 can permit the passage of one ormore sutures 116 through the bottom portion 124 and around the internalpost 120. The suture 116 can thereby slide freely around the internalpost 120 to regulate a position or tension of the suture 116. Althoughillustrated as adjacent to the distal end 106 of the suture anchor 100,it should be understood that the internal post 120 can be positioned atany point within the second cavity 114 such that the locking pin can beinserted into and sufficiently maintained within the top portion 122.

With reference to FIGS. 3A and 3B, top views of the proximal end 104 ofthe suture anchor 100 and the internal cavity 110 are provided. In someembodiments, the first cavity 112 can be configured for a hexagonaldriver (FIG. 3A) or a square driver (FIG. 3B). In some embodiments, thefirst cavity 112 can be configured for alternative drivers, e.g.,slotted drivers, fluted drivers, and the like, so long as the firstcavity 112 remains complementary to the configuration of an interlockingdriver or driver handle. In addition, although the second cavity 114 isillustrated as circular, in some embodiments, the second cavity 114 canbe configured as, e.g., square, rectangular, triangular, and the like,so long as the configuration of the second cavity 114 remainscomplementary to the configuration of the locking pin.

Turning now to FIGS. 4 and 5, the suture anchor 100 is provided with anexemplary driver 200. The driver 200 generally includes an elongatedtubular or hollow shaft 202 which defines a distal end 204 and aproximal end 206. The distal end 204 of the shaft 202 can be configuredand dimensioned to be inserted into and interlocked with the firstcavity 112 of the suture anchor 100. For example, the distal end 204 ofthe shaft 202 can be configured as a hexagon which can enter into andinterlock relative to the hexagonal configuration of the first cavity112 of the suture anchor 100. Thus, rotation of the driver 200 canimpart a torque on the suture anchor 100 for driving the suture anchor100 into tissue and/or bone.

The proximal end 206 of the shaft 202 can be connected to a driverhandle 208. Although illustrated as defining a smooth outer surface, insome embodiments, the driver handle 208 can include ridges and/or afriction-imparting surface to prevent slippage of a user's hand duringgripping or twisting of the driver handle 208. The driver handle 208 caninclude a post 210 extending therefrom around which the suture 116 canbe wrapped. In some embodiments, the suture 116 can be passed around theinternal post 120 of the suture anchor 100, passed out of the internalcavity 110 and wrapped around the post 210 of the driver handle 208 tolock the suture anchor 100 relative to the driver 200 to preventundesired removal of the distal end 204 of the shaft 202 from the firstcavity 112 of the suture anchor 100.

The driver 200 can include an internal locking pin driver 212. Theinternal locking pin driver 212 can be configured as an elongated rodpassing through an aperture 214 formed in the driver handle 208 andthrough an internal cavity 216 formed in the shaft 202. A proximal end218 of the locking pin driver 212 can include a cap 220 or handle and adistal end 222 of the locking pin driver 212 can include a locking means224, e.g., threading, for interlocking relative to an internal lockingpin 226. For example, the locking pin 226 can be passed into theinternal cavity 216 of the shaft 202 and the locking pin driver 212 canbe interlocked relative to the locking pin 226 by threading the lockingmeans 224 into a complementary threaded cavity at the proximal end ofthe locking pin 226. Thus, axial translation of the locking pin driver212 can simultaneously axially translate or deploy the locking pin 226in and out of the distal end 204 of the shaft 202.

As can be seen from FIGS. 4 and 5, the suture 116 can be slidablypreloaded or passed around the internal post 120 and out of the sutureanchor 100. To interlock the driver 200 and the suture anchor 100, thedistal end 204 of the shaft 202 can be inserted into the first cavity112, i.e., the driver/anchor interface, until the distal end 204 abutsthe edge 118 of the suture anchor 100. In particular, the walls of theinternal cavity 216 of the shaft 202 can be substantially aligned withthe internal walls of the second cavity 114 of the suture anchor 100.The sutures 116 can be wrapped around the post 210 to secure the driver200 relative to the suture anchor 100. The anchor sutures 116 wrappedaround the post 210 can provide longitudinal tension along the handle208 and/or driver 200, further locking and holding the suture anchor 100on the distal end 204 or tip of the driver 100 at the driver/anchorinterface.

In sliding suture 116 embodiments, the driver 200 can then be axiallyrotated to drive the suture anchor 100 into the tissue and/or bone, thesuture 116 can be unwrapped from the post 210 of the driver handle 208,and the driver 200 can be disengaged from the suture anchor 100. Thesuture 116 can thereby remain in a sliding engagement with the sutureanchor 100. It should be understood that in sliding suture 116embodiments, inclusion of the locking pin 226 within the shaft 202 ofthe driver 200 may not be necessary. However, the locking pin 226 can beimplemented within the driver 200 even in sliding suture 116applications to allow a user to decide during application of the sutureanchor 100 whether a sliding or a non-sliding suture 116 application isdesired.

In non-sliding suture 116 embodiments, after the driver 200 has beenimplemented for driving the suture anchor 100 into the tissue and/orbone, the locking pin driver 212 can be depressed against the handle 208such that the cap 220 abuts the top of the handle 208 (see, e.g., FIG.6). It should be understood that the suture anchor 100 can be driveninto tissue and/or bone with the driver 200 without advancing theinternal locking pin 226. When advancement of the locking pin 226 isdesired, the locking pin driver 212 can be depressed to advance thelocking pin driver 212 and the internal locking pin 226 from the shaft202 and into the second cavity 114 of the suture anchor 100. In someembodiments, advancement of the locking pin 226 can be performed with,e.g., a screw design, mechanical or automatic actuation of the lockingpin driver 212, and the like (not shown). As will be discussed ingreater detail below, the locking pin 226 can be configured anddimensioned to lock the suture 116 against the internal walls of thesecond cavity 114 such that the suture 116 cannot be pulled in or out ofthe suture anchor 100. The locking pin driver 212 can then be disengagedfrom the locking pin 226 by, e.g., unscrewing the locking means 224 fromthe locking pin 226, the sutures 116 can be unwrapped from the post 210,and the locking pin driver 212 and the driver 200 can be disengaged fromthe suture anchor 100. Thus, non-sliding suture 116 applications can beused with the exemplary suture anchor 100.

With reference to FIG. 7, a side, cross-sectional detailed view of aninterlocked driver 200 and suture anchor 100 is provided, for example,prior to deployment into tissue and/or bone. In particular, FIG. 7 showsa driver 200 with a locking pin 226 retracted into the internal cavity216 of the shaft 202 and away from the suture anchor 100. In someembodiments, the preloaded suture 116 can pass around the internal post120 of the suture anchor 100 and out of the suture anchor 100 throughopenings (not shown) in the sides of the shaft 202. In some embodiments,the preloaded suture 116 can pass around the internal post 120 of thesuture anchor 100, around the distal end 204 of the shaft 202, and outof the suture anchor 100. The locking means 224 between the locking pindriver 212 and the locking pin 226 can also be seen in FIG. 7. In someembodiments, the locking means 224 can include a complementary mini-finethread interface between the locking pin driver 212 and the locking pin226.

With reference to FIG. 8, the suture anchor 100 is shown after beingdriven into tissue and/or bone 300 for a sliding suture 116 application.In particular, the suture anchor 100 has been driven into the tissueand/or bone 300 with the driver 200, the driver 200 has been disengagedfrom the suture anchor 100 without advancement of the locking pin 226into the second cavity 214 of the suture anchor 100, and the suture 116has been unwrapped from the post 210 of the handle 208. Thus, thelocking pin 226 remains within the body or internal cavity 216 of theshaft 202 and the suture 116 can freely slide around the internal post120 of the suture anchor 100.

FIGS. 9 and 10 illustrate the implementation of the suture anchor 100and the driver 200 for non-sliding applications. In particular, once thesuture anchor 100 has been driven into the tissue and/or bone 300, thelocking pin driver 212 can be depressed against the handle 208 toadvance the locking pin 226 into the second cavity 114 of the sutureanchor 100. Advancement of the locking pin 226 into the second cavity114 can push the sutures 116 against the inner walls of the secondcavity 114 to provide, e.g., an interference fit, a frictional lock fit,and the like, which prevents the sutures 116 from sliding around theinternal post 120. Thus, the configuration and dimensions of the lockingpin 226 and the second cavity 114 can be determined such that one ormore sutures 116 can fit between the locking pin 226 and the secondcavity 114 walls, while an interference fit and/or frictional fit iscreated due to the pressure of the locking pin 226 against the sutures116 and the second cavity 114 walls. In some embodiments, rather than orin addition to the friction or interference fit, the outer surfaces ofthe locking pin 226 can include threads and the inner surfaces of thesecond cavity 114 can include threading complementary to the threads onthe locking pin 226. Thus, the locking pin 226 can be threaded into thesecond cavity 114 of the suture anchor 100 to press the sutures 116against the side walls of the second cavity 114 and/or against theinternal post 120.

Although illustrated in FIGS. 9 and 10 as being positioned in a spacebetween the internal post 120 and the first cavity 112, i.e., spacedfrom the internal post 120, in some embodiments, the locking pin 226 canbe advanced into the second cavity 114 until the locking pin 226 abutsthe internal post 120. In some embodiments, the locking pin 226 can bedimensioned to extend from the internal post 120 to the edge 118 of thesuture anchor 100, i.e., the full length of the untapered section of thesecond cavity 114. In some embodiments, the locking pin 226 dimensioncan be varied so long as the locking pin 226 provides sufficient surfacearea for maintaining the sutures 116 within the second cavity 114 of thesuture anchor 100. The sutures 116 can then be unwrapped from the post210 of the handle 208, the locking means 224 of the locking pin driver212 can be disengaged, e.g., unscrewed, from the complementary lockingmeans 228 in the locking pin 226 (see, e.g., FIG. 10), and the shaft 202can be withdrawn from the first cavity 112 of the suture anchor 100.

Turning now to FIGS. 11-15, knotless techniques or applications ofsecuring sutures 116 with the suture anchor 100 are provided. Forexample, the knotless techniques can be used to secure sutures 116 whichhave already been passed through soft tissue 400. Therefore, in someembodiments, the suture anchors 100 can be used as suture 116 shuttles.One suture 116 or suture limb can be passed through the soft tissue 400,e.g., tendon, and can be extended out of the soft tissue 400. A secondsuture 116 or suture limb can be slidably preloaded into the sutureanchor 100 prior to driving the suture anchor into the tissue and/orbone 300. The second suture 116 protruding out of the suture anchor 100can be secured to the first suture 116 extending out of the soft tissue400 by, e.g., tying knots 126 between the two sets of sutures 116. Bypulling on the suture 116 limbs of the anchor suture 116 as illustratedby the arrows of FIG. 11, the soft tissue 400 sutures 116 can beshuttled around the suture anchor 100 bottom portion 124, i.e., eyelet,and the internal post 120 and through the anchor body 102 of the sutureanchor 100. The sutures 116 passing through the soft tissue 400 canthereby be tightened through the suture anchor 100.

When the appropriate tendon or soft tissue 400 reduction and/or suture116 tension has been achieved, the user can decide whether the lockingpin 226 should be advanced into the suture anchor 100. FIG. 13illustrates an implementation of the knotless technique with an advancedlocking pin 226. In particular, the sutures 116 have been pulled throughthe suture anchor 100 to tighten the sutures 116 relative to the softtissue 400 and/or to reduce the soft tissue 400 towards the sutureanchor 100 and the locking pin 226 has been advanced into the secondcavity 114 of the suture anchor 100 to lock the sutures 116 against theinner walls of the second cavity 114. The sutures 116 can thereby belocked in place in a knotless manner. It should be understood that oncethe locking pin 226 has been advanced into the suture anchor 100, thedriver 200 can be disengaged from the suture anchor 100 as discussedabove.

FIG. 14 illustrates an implementation of a single-row, sliding techniquewithout advancing the locking pin 226 into the suture anchor 100. Inparticular, the suture 116 has been pulled through the suture anchor 100to tighten the suture 116 relative to the soft tissue 400 and/or toreduce the soft tissue 400 towards the suture anchor 100 and a knot 126has been tied to connect the two sides of the suture 116 relative toeach other. The knot 126 can be tied to maintain the desired tension ofthe sutures 116 relative to the soft tissue 400. In addition, the suture116 can freely slide relative to the suture anchor 100.

In some embodiments, as shown in the single-row, non-sliding techniqueof FIG. 15, the knot 126 can be implemented to secure the two sides ofthe suture 116 relative to each other in conjunction with the advancedlocking pin 226. Thus, for example, only one portion of the suture 116can be passed around the internal post 120 of the suture anchor 100 andthe locking pin 226 can be advanced into the second cavity 114 to securethe suture 116 against the inner walls of the second cavity 114 with,e.g., a friction fit, and interference fit, and the like. The driver 200can be disengaged from the suture anchor 100 and the suture 116protruding from the suture anchor 100 can be tied with a knot 126 to thesuture 116 protruding from the soft tissue 400 for a non-sliding suture116 application.

In addition to the single-row techniques described above, the one ormore suture anchors 100 can be used to perform double-row fixation ofsoft tissue to bone. FIG. 16 shows a knotted, double-row technique usinga medial suture anchor 100 a and a lateral suture anchor 100 b. Inparticular, the medial suture anchor 100 a can be slidably preloadedwith a suture 116 around the internal post 120 and the medial sutureanchor 100 a can be driven into the tissue and/or bone 300 underlyingthe soft tissue 400. The sutures 116 of the medial suture anchor 100 acan be used in a sliding manner, i.e., a locking pin 226 is not used tosecure the suture 116 relative to the medial suture anchor 100 a, andthe sutures 116 can be further passed through the medial aspect of thesoft tissue 400, e.g., a tendon. A knot 126 can then be tied in thesuture 116 on the superior surface of the soft tissue 400. Further, thesuture 116 ends can be shuttled through the lateral suture anchor 100 bdriven into the adjacent tissue and/or bone 300 and an internal lockingpin 226 can be used to secure the suture 116 within the lateral sutureanchor 100 b. Thus, the desired tension in the suture 116 can bemaintained.

FIG. 17 shows a knotless, double-row technique using a medial sutureanchor 100 a and a lateral suture anchor 100 b. In particular, themedial suture anchor 100 a can be slidably preloaded with a suture 116around the internal post 120 and the medial suture anchor 100 a can bedriven into the tissue and/or bone 300 underlying the soft tissue 400.The sutures 116 of the medial suture anchor 100 a can be used in anon-sliding manner by advancing a locking pin 226 into the second cavity114 of the medial suture anchor 100 a to secure the sutures 116 therein.The sutures 116 can then be passed through the medial aspect of the softtissue 400, e.g., a tendon. Due to the non-sliding nature of the sutures116 relative to the medial suture anchor 100 a, a knot does not need tobe tied on the superior surface of the soft tissue 400. In someembodiments, a user can tie a knot 126 substantially similar to the knot126 shown in FIG. 16 on the superior surface of the soft tissue 400 foradditional fixation of the suture 116. The suture 116 ends can then beshuttled through the lateral suture anchor 100 b driven into theadjacent tissue and/or bone 300 and an internal locking pin 226 can beused to secure the suture 116 within the lateral suture anchor 100 b. Insome embodiments, the suture 116 ends can be preloaded into the lateralsuture anchor 100 b prior to driving the lateral suture anchor 100 binto the tissue and/or bone 300. Thus, the desired tension in the suture116 can be maintained.

While exemplary embodiments have been described herein, it is expresslynoted that these embodiments should not be construed as limiting, butrather that additions and modifications to what is expressly describedherein also are included within the scope of the invention. Moreover, itis to be understood that the features of the various embodimentsdescribed herein are not mutually exclusive and can exist in variouscombinations and permutations, even if such combinations or permutationsare not made express herein, without departing from the spirit and scopeof the invention.

1. A suture anchor, comprising: a suture anchor body including asecuring structure for securing the suture anchor in tissue or bone,wherein the suture anchor body includes an internal cavity configuredand dimensioned to receive therein a suture and a locking pin.
 2. Thesuture anchor according to claim 1, wherein the suture anchor body isadapted for sliding, non-sliding and knotless suturing techniques. 3.The suture anchor according to claim 1, wherein the securing structureis at least one of threads, an interference fit surface, and aretractable harpoon.
 4. The suture anchor according to claim 1, whereinthe suture anchor body comprises an additional internal cavity locatedadjacent to the internal cavity configured and dimensioned to interlockwith a driver for driving the suture anchor into the tissue or bone. 5.The suture anchor according to claim 1, wherein the internal cavitycomprises an internal post forming an eyelet in the internal cavity. 6.The suture anchor according to claim 5, wherein the eyelet is configuredand dimensioned to receive the suture therethrough.
 7. The suture anchoraccording to claim 1, wherein the suture anchor body is fabricated froma group consisting of a metal, a bioabsorbable material, a biocompositematerial, and a polyether ether ketone.
 8. A suture anchor system,comprising: a suture anchor including (i) a suture anchor body includinga securing structure for securing the suture anchor in tissue or bone,wherein the suture anchor body includes an internal cavity configuredand dimensioned to receive therein a suture and a locking pin, and adriver configured and dimensioned to interlock relative to the sutureanchor.
 9. The suture anchor system according to claim 8, wherein thedriver comprises a driver handle and a shaft.
 10. The suture anchorsystem according to claim 9, wherein the suture anchor body comprises anadditional internal cavity to receive a distal end of the shaft.
 11. Thesuture anchor system according to claim 9, wherein the driver handlecomprises a post for wrapping the suture thereon to lock the driverrelative to the suture anchor.
 12. The suture anchor system according toclaim 9, wherein the driver comprises a locking pin driver detachablysecured to the locking pin with locking means, wherein the locking pindriver and the locking pin are translatable relative to the driverhandle and the shaft.
 13. The suture anchor system according to claim12, wherein the internal cavity comprises an internal post forming aneyelet in the internal cavity, and wherein the eyelet is configured anddimensioned to receive the suture therethrough.
 14. The suture anchorsystem according to claim 13, wherein advancement of the locking pininto the internal cavity fixedly secures the suture within the internalcavity.
 15. A method of anchoring a suture in tissue or bone, the methodcomprising: providing a suture anchor, the suture anchor including (i) asuture anchor body including a securing structure for securing thesuture anchor in the tissue or bone, wherein the suture anchor bodyincludes an internal cavity configured and dimensioned to receivetherein the suture and a locking pin, passing the suture through thesuture anchor body, and driving the suture anchor into the tissue orbone.
 16. The method according to claim 15, comprising interlocking thesuture anchor with a driver for driving the suture anchor into thetissue or bone.
 17. The method according to claim 16, comprisingwrapping the suture around a post protruding from a driver handle. 18.The method according to claim 17, comprising disengaging the driver fromthe suture anchor and slidably translating the suture through the sutureanchor body for a sliding suture application.
 19. The method accordingto claim 17, comprising advancing the locking pin into the internalcavity with a locking pin driver and fixating the suture againstinternal walls of the internal cavity for a non-sliding sutureapplication.
 20. The method according to claim 19, comprisingdisengaging the locking pin driver from the locking pin.